Androgen therapy

Palliation of inoperable breast cancer in women-200 to 400 mg every 2 to 4 weeks. Androgen therapy occasionally appears to accelerate metastatic breast carcinoma. 

Breast cancer Androgen therapy may cause hypercalcemia by stimulating osteolysis. 

When androgen therapy is used in postmenopausal women who complain of poor libido, poor energy, or a feeling of malaise (2), it should be given in association with estrogens, because of its adverse effects on serum lipids. 

The safety of androgen therapy for cardiovascular and prostatic disease is uncertain. Kraus, after a careful review of the literature from a German perspective, has pointed out that androgen substitution must be approached with caution even if the hazards are dubious, the need for such treatment is even more doubtful .The lack of clear hazards from testosterone substitution in the aging male does not indicate unrestricted treatment safety. Until all doubts are cleared, each treatment should be carefully documented and monitored (23). 

Liu PY, Swerdloff RS, Veldhuis JD. The rationale, efficacy and safety of androgen therapy in older men future research and current practice recommendations. J Clin Endocrinol Metab 2004 89 4789-96. 

Crook D. Androgen therapy in the aging male assessing the effect on heart disease. Aging Male 1999 2 151-6. 

A marked rise in blood glucose concentration must be a very rare effect of anti-androgen therapy, but a Japanese group has described two patients with prostate cancer with this complication (43). 

All in all, it seems very doubtful whether any of the supposed benefits of androgen therapy justify the risks involved, except possibly as a transitional measure in those recently oophorectomized women who have acute symptoms of sudden androgen withdrawal. 

Barrett-Connor E. Efficacy and safety of estrogen/androgen therapy. Menopausal symptoms, bone, and cardiovascular parameters. J Reprod Med 1998 43(Suppl 8) 746-52. 

Androgen therapy for anemia of chronic renal failure... 

Navarro JF, Mora C. Androgen therapy for anemia in elderly uremic patients. Int Urol Nephrol. 2001 32 549-557. 

Rogol AD. Pubertal androgen therapy in boys. Pedi-atr Endocrinol Rev. 2005 2 383-390. 

Strawford A, Barbieri T, Van Loan M, et al. Resistance exercise and supraphysiologic androgen therapy in eugonadal men with HIV-related weight loss a randomized controlled trial. JAMA. 1999 281 1282-1290. 

The exact mechanism of this adverse effect is not known. Several cases of priapism have been reported, and it has been hypothesized that androgen therapy probably contributes (107). 

The masculinizing effects of the AAS preclude their use in most circumstances in women. Secondary treatment of advanced or metastatic breast carcinoma in selected patients is generally considered to be the only indication fur large-dose. long-term androgen therapy in women. In lower doses, androgen replacement therapy is more often being considered for use in menopausal and postmenopausal women for the positive effects on libido, mood, vasomotor. symptoms. 

Gooren LJ and Polderman KH (1990) Safety aspects of androgen therapy. In Nieschlag E and Behre HM (eds.) Testosterone Action, Deficiency and Substitution, pp. 182-203. Berlin Springer. 

Fig. 36. Case A. Hyperphosphatasemia during androgen therapy in cancer of the endometrium. D-total = total alkaline phosphatase activity, non-LPSAP = activity in the presence of L-phenylalanine open circles, and n — l = LPSAP, closed circles. The same symbols apply to Figures 37, 38, and 39.

Fig. 37. Case B. Hyperphosphatasemia in androgen therapy of cancer of the breast. See Fig. 36.

Case C (Fig. 38). A female patient with cancer of the breast metastatic to bone exhibited a drop in serum alkaline phosphatase while on androgen therapy. This diminution can be attributed to the loss of... 

There are no data regarding the effects of exogenous androgen therapy on the incidence of breast cancer. However, androgen receptors are found in approximately 50% of mammary tumors, and their presence is associated with longer survival in women with operable breast cancer. ... 

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